England's Cardiovascular Burden Beyond COVID

Cardiovascular diseases continue to represent one of the most pressing challenges in public health. The COVID-19 pandemic was associated with heightened risks of heart-related complications in people with pre-existing conditions, an increase in newly emerging cardiovascular cases, and widespread interruptions to standard medical care (1^✔ ✔Trusted Source
Health data for 57 million people in England show changing patterns of heart diseases before, during and after the pandemic

Go to source). To gain a detailed and population-wide perspective, scientists examined interconnected health records from more than 57 million individuals across England, evaluating how the pandemic influenced 79 separate cardiovascular disorders.

Unequal Impact of the COVID-19 Pandemic on Cardiovascular Health

Co-author Professor William Whiteley, Associate Director at the BHF Data Science Centre, said:

“Our findings show that during the COVID-19 pandemic there were drops in the incidence of some cardiovascular disease, and that disparities in the burden of these conditions were borne unequally by England’s diverse population.

“But diagnosis rates of many conditions have since returned to pre-pandemic levels, and our insights could provide a foundation to push healthcare resources fairly to who and where they’re needed most. Detecting cases of cardiovascular disease in a targeted and timely way opens up more windows for us to intervene, saving and improving lives.”

Rise in Heart-Related Conditions and Uneven Recovery

Co-author Professor Angela Wood, University of Cambridge and Associate Director at the BHF Data Science Centre, said:

“During the pandemic, we saw marked rises in the prevalence of conditions like ischemic stroke and heart failure. Although our study did not investigate reasons behind these trends, we believe these observations may reflect the direct effects of the COVID-19 virus, as well as the indirect effects of disruption to healthcare delivery and delayed care.

“Harnessing whole population data in a responsible, trustworthy, and secure manner can help us to pinpoint health inequalities, track changes over time, and influence policy decision making. Our findings could also inform preparation for future pandemics.”

Comprehensive Data Covering the Entire Population

The data from hospital, primary care, death and specialist registries covered 1 January 2020 and 31 May 2024.

All personal information that could identify individuals had been stripped away, and approved researchers accessed this data entirely within the NHS England Secure Data Environment (SDE), a secure data and analysis platform.

For each heart condition, they looked at incidence, prevalence, short-term mortality, and subsequent cardiovascular events, comparing changes before and after the pandemic and across demographic variables like age, sex, ethnicity, deprivation, and existing long-term conditions.

Decline in Diagnoses During Lockdowns but Higher Fatality Rates

The researchers found that the number of new diagnoses of heart conditions fell during the first COVID-19 lockdown in 2020.

However, the people who received these diagnoses were more likely to die than at other times during 2020 to 2024. They believe this decrease is because healthcare services were under severe pressure and only the most seriously ill people were seeking care.

Ethnic and Geographic Variations in Cardiovascular Outcomes

There was a lot of variation between ethnicities. People of Bangladeshi, Indian, and Pakistani ethnicities were more likely to be diagnosed with coronary vascular disease, while people of African, Caribbean, and other Black ethnicities were more likely to experience conditions related to high blood pressure. But diagnoses of these conditions tended to be less fatal than for the White British population.

Geographical location and deprivation also influenced the rates and numbers of cardiovascular diagnoses. For example, there was higher case fatality for heart attacks and stroke in the North, Midlands, and parts of the South, as well as in coastal areas of the East.

Cardiovascular Diagnoses and Death Rates in 2024

Comparing before and after the pandemic, the researchers found that in 2024, the number of new cardiovascular diagnoses was up compared with before the pandemic.

In particular, they saw increases in the incidence (26%), prevalence (50%), and short-term mortality (from 8.5% to 17%) of myocarditis, as well as a 25% increase in the prevalence of heart failure.

However, the researchers believe these increases are in part due to healthcare services catching up in the wake of the pandemic, with more diagnoses now being possible as pressure eases and professionals improve symptom recognition.

Advancing Research and Policy Through Data Access

The researchers have developed a dashboard to help researchers, policymakers, and the public to access and interpret their findings. This will be available on the BHF Data Science Centre’s website.

The researchers were able to carry out this study under measures put in place during the pandemic to enable COVID-19-related research. In their paper, they note that this approach could continue to provide detailed readouts of cardiovascular diagnoses and inform policy, research, and care planning if access to linked data were extended beyond COVID-19.

Mapping Inequalities to Drive Future Action

Principal author Dr Elias Allara at the University of Cambridge said:“This study paints England’s burden of cardiovascular disease in unprecedented detail, and research like this is only possible at low cost by leveraging and linking health data on a whole population scale. By revealing where the biggest gaps are in cardiovascular diagnosis and care, our findings lay the groundwork for action to tackle these important inequalities.”

Reference:

1. Health data for 57 million people in England show changing patterns of heart diseases before, during and after the pandemic - (https://bhfdatasciencecentre.org/news-and-events/health-data-for-57-million-people-in-england-show-changing-patterns-of-heart-diseases-before-during-and-after-the-pandemic/)

Source-Health Data Research UK